Obstructive Sleep Apnea: Emphasis On Discharge Education After Surgery

Purpose: The purpose of this evidence-based practice project is to evaluate the effectiveness of discharge education (DCE) on obstructive sleep apnea (OSA) for increasing continuous positive airway pressure (CPAP) compliance after surgery among adult surgical patients diagnosed with OSA, who use CPAP. Background & Evidence for Problem: In the United States, the prevalence of OSA in the adult population is approximately 20%. Over half of the surgical patients with OSA are predisposed to increased incidence of perioperative complications. Based on recent evidence, obstructive events are at the highest on the third day after surgery, which predisposes them for postoperative complications. The American Society of Perianesthesia Nurses recommends that a DCE on OSA should be provided after surgery to patients diagnosed with OSA to promote CPAP compliance and self-care behaviors at home. Project Plan: Participants were adult surgical patients over 18 years old diagnosed with OSA, who use CPAP. Phase one was completed using the Apnea Knowledge Test to measure patients’ knowledge on OSA. Phase two included a second set of surgical patients that were provided DCE on OSA by telephone, five to seven days before surgery. Education was reinforced on the day of surgery and seven to 10 days after surgery. Outcomes measured were CPAP usage and the Epworth Sleepiness Scale score to evaluate effectiveness of this EBP project. Outcomes / Results: Sixty-six participants were provided DCE on OSA. In phase one, the mean patients’ knowledge demonstrated a 23.9% increase from pretest to three days after discharge. In phase two, the mean CPAP hours per night usage increased by a total of 72 minutes after DCE on OSA provided. There was no clinically significant change in ESS over time. Conclusions: Not only does the DCE on OSA increase patient’s knowledge on OSA and CPAP usage, it also demonstrated effectiveness in increasing CPAP compliance after surgery. The DCE on OSA could be implemented in the surgical setting as part of routine clinical care